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Vlad the Impaler -

A new chemical analysis of the terrifying 15th-century prince Vlad III, also known as Vlad the Impaler, revealed that he cried tears of blood. Along with haemolacria, he may also have had skin and respiratory conditions. But what is haemolacria, really?

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What is haemolacria? -

Crying bloody tears is a rare condition that causes a person to produce tears tinged with, or partially made of, blood.

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It's often a symptom of another condition -

In many cases, haemolacria is a symptom of another condition and is usually benign.

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But it can be serious -

However, if you begin to experience blood mixed with your tears, recurrent cases, or accompanying symptoms, seek immediate medical attention.

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How are tears produced? -

The lacrimal gland is a large gland located under the eyelid that emits tears onto the surface of the eye. Tiny glands that produce tears are also embedded in the eyelid.

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How tears drain -

Each eyelid typically has one punctum, or opening of a tear duct, which is easily seen on the surface of the eyelid margin. Each punctum has a small tube that leads to the nasolacrimal sac, opening into the nose.

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The function of tears -

The tears themselves supply a lubrication function to the eye, as well as help the eye to create an optically clear image. They also protect your eyes from infections and irritating things, like dirt and dust.

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Causes for crying blood -

Now that you know how tears are made, let's dive into the main causes of bloody tears.

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Eye injuries -

The conjunctiva is a clear tissue membrane that lies on top of the white part of the eye. It has a meshwork of blood vessels. And sometimes infection, inflammation, or conjunctival injuries can cause bleeding of the conjunctiva.

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Nosebleeds -

The lacrimal system that produces and drains human tears is connected to the nasal cavity. This is why your nose gets congested when you cry.

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Nosebleeds -

If you have a nosebleed and blow or pinch your nose, a reverse flow of blood can be pushed back up through the nasolacrimal system. This will cause blood to regurgitate into the tears, making it appear that they're composed of blood.

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Medications -

Conditions that require taking blood thinners can also cause people to have bloody tears.

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Blood disorders -

Blood disorders, including hemophilia, can cause excessive bleeding due to clotting problems.

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Blood disorders -

People suffering from hemophilia may bruise or bleed easily. This can show up as bloody tears.

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Benign tumors -

A pyogenic granuloma is a benign (non-cancerous) tumor that can grow on the conjunctiva or in the lacrimal sac. Small lesions in this area can cause bloody tears.

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Uncontrolled high blood pressure -

Although rare, bloody tears have been documented in cases of untreated high blood pressure.

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Hormonal changes -

Studies have documented haemolacria during menstruation. Usually found in small amounts, the bleeding is most likely caused by hormonal changes.

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Cancer -

Cancers on the lacrimal sac, lacrimal gland, and the conjunctiva can also produce bloody tears. These are very serious conditions that require prompt treatment.

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Idiopathic cause -

There have also been many cases where no serious disease or disorders have been found, and the condition appears to resolve itself with time.

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How is haemolacria diagnosed? -

If you're crying blood, visit a doctor so that you can understand the cause and develop a treatment plan.

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Prepare for tests -

You are likely to undergo extensive tests and examinations. You'll also be asked about your personal and family medical history, medications, and any recent eye injuries or other bleeding.

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Common diagnostic tests -

Diagnostic tests may include sinus CT scan, nasal endoscopy, punctual plugs, and taking cultures to identify abnormalities.

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Referral to an ophthalmologist -

You may also be referred to an ophthalmologist, a physician who specializes in eye and vision care.

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Treatment for haemolacria -

Effective treatment for haemolacria ultimately depends on underlying causative factors.

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Possible treatments -

For example, medications may be prescribed for high blood pressure, or radiation may be recommended for eye melanoma.

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A wait-and-see approach -

In some cases, haemolacria may only require some monitoring until it clears on its own.

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Medications -

Your healthcare provider may also flush your eye and prescribe medications such as antibiotics to help prevent infection.

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Stenting -

Another possible recommendation is stenting. This is when a tiny mesh is placed into a newly opened artery area to prevent it from narrowing or closing up.

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Surgery -

Surgery and other invasive procedures may only be required in more serious cases.

Sources: (Verywell Health) (Healthline) (The Independent) 

See also: The most common skin conditions, and their cures

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